As of the July, 2022, release via CMS

METRO NASHVILLE GENERAL HOSPITAL

CMS id: 440111
1818 ALBION STREET, NASHVILLE TN 37208. County: DAVIDSON
System: --
CBSA: Nashville-Davidson--Murfreesboro--Franklin, TN

The 114-bed, acute-care hospital had $-63,661,126 in net service to patients*, with a total profit margin of 3.63512% in fiscal year 2021, the latest year available.
It spent 24.16% of its operating expenses on uncompensated care and reported $9,229,346 in Medicaid shortfall.

* For more about Net Service to Patients and operating revenue, please the finance section below.

Note: Medians are from acute-care hospitals with "complete" fiscal years. For more about how we calculated medians and cost reports in general, please click here.

Details

	2017	2018	2019	2020	2021
# of days in fyear	365	365	365	366	365
Ownership	gov	gov	gov	gov	gov
Acute beds Median	82 118	82 118	82 119.5	82 118	82 119
Total beds Median	114 162	114 162	114 162	114 162	114 163.5
FTEs Median	623.26 788.06	562.63 793.42	558.41 806.03	580.01 787.61	590.62 804.34

Finances As they appear in worksheet G3 of the cost reports.

Note: Net Patient Revenue is considered operating revenue, which means Net Service to Patients is considered operating profit. Click here for more about cost report financials

Hospital cost reports are an enormously complicated dataset. There are whole organizations and an offical CMS vendor dedicated to helping researchers work with the data.
It's important to understand that hospital financials in cost reports are not organized in the same as other sources such as annual financial reports to bond holders.

The biggest difference is the concept of operating revenue and profit. Net Service to patients (NS2P), which is the sum of net patient revenue minus operating expenses, is considered the equivalent of operating profit according to the Medicaid and CHIP Payment and Access Commission (MACPAC). See the last paragraph of "Primary Data Sources" on page 55 of Annual Analysis of Disproportionate Share Hospital Allotments to States (PDF).

That would make Net Patient Revenue = operating revenue.

All this makes things challenging when comparing what's reported in cost reports to other sources. It becomes clearer when you consider that, beyond the purpose of reimbursement, cost reports are a tool for policymakers trying to understand the financial situation of a hospital doing the tasks specific to hospitals.

In other words, while a facility with a division that formulates drugs might include earnings from that as operating revenue in their corporate annual result, this is not central to the operations of a hospital caring for patients and so it is counted as "other income." (See below the financials section for more on "other income")

The healthcare consulting firm HMP, in a former partnership with Modern Healthcare, did develop a formula for estimating operating revenue closer to what one might find in other sources. We no longer use this for the following reasons:

The measure was not widely used beyond HMP and Modern Healthcare. Many hospitals had their own internal estimates of operating revenue and profit.
Because of this, there was confusion when reporting operating results for individual hospitals. There was often pushback when a facility's internal numbers did not match what Modern Healthcare was reporting.
The formula includes revenue from portions of the "other income" section, which may also include non-operating revenue. HMP themselves point out in a caveat on their site that they cannot exclude all non-operating revenue from their measure.

HMP's operating measure has proven problematic in the past for our reporting and the partnership with them ended years ago. It's best to not use a measure that we alone cannot defend.

	2017	2018	2019	2020	2021
Net patient revenue ? Median	42,390,978 150,932,746	40,820,482 158,950,878	41,752,427 168,696,998	38,691,894 163,454,693	54,351,869 186,589,412
Operating expenses Median	103,990,155 149,311,209	103,720,731 156,110,414	104,872,317 164,890,568	108,834,470 166,516,854	118,012,995 180,120,888
Net income from service 2 patients (NS2P) ? Median	-61,599,177 -964,173	-62,900,249 -643,601.5	-63,119,890 -116,254	-70,142,576 -5,025,862	-63,661,126 -1,284,564
NS2P margin ? Median	-145.31% -0.62	-154.09% -0.29	-151.18% 0.18	-181.28% -5.07	-117.13% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for METRO NASHVILLE GENERAL HOSPITAL compared to all** acute-care hospitals, from CMS cost reports.
Note: NS2P is considered operating margin by MACPAC. The chart below is interactive: click or touch to see more.

* Data range does not show outliers, which fall beyond the minimum and maximum of the range.
** From cost reports with complete fiscal years. Number of acute-care hospitals available to calculate medians:

2017	2018	2019	2020	2021
3,157	3,092	3,050	3,052	2,566

	2017	2018	2019	2020	2021
Other income* Median Click here to show/hide details	75,143,060 5,089,215	68,532,661 4,572,541	63,488,758 5,268,134	65,522,534 13,092,619	68,112,868 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	28,088 224,999	0 199,009	0 206,870.5	0 194,343	23,862 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	55,642 188,688.5	87,401 370,813	71,311 309,361.5	0 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	96,201	0	0	0	0
⊳ Line 11: Rebates and refunds of expenses	0	1,540	13,757	17,270	41,668
⊳ Line 12: Parking lot receipts	0	0	0	0	0
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	363,546	488,100	501,763	478,191	356,782
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	0	0	0	0	0
⊳ Line 17: Revenue from sale of drugs to other than patients	0	0	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	16,410	0	0	15	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	284,189	188,684	159,771	129,776	248,906
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	1,223,215	1,255,342	846,660	805,000	480,826
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	64,782,629 983,261.5	60,215,543 1,173,286	44,472,650 1,987,202	58,735,517 1,597,664
⊳ Sum Line 24	73,131,411	1,760,724	1,663,863	19,548,321	8,225,307
Total income ? Median	13,543,883 6,586,430	5,632,412 6,767,106	368,868 8,419,950	-4,620,042 8,094,175	4,451,742 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	13,543,883 6,043,842	5,632,412 5,845,112	368,868 7,606,259	-4,620,042 7,283,041	4,451,742 14,957,241
Net margin Median	11.52337% 4.62%	5.15066% 4.42%	0.35050% 5.16%	-4.43321% 5.2%	3.63512% 9.25%

* About "Other income": Other income, or line 25 in worksheet G3, is the sum of lines 6 through 24. It includes three lines that are considered non-operating revenue - contributions, investments and government appropriations. Medians are included for these three lines. It also contains items that are not central to providing healthcare, such as revenue from parking or gift shops.
"Sum Line 24" is a special case. Called "Other (specify)" in the cost reports, CMS allows for this line to be "subscripted," or divided into sublines like 002400, 002401, 002402. And hospitals do that, up to 100 lines, to detail income (and sometimes negative returns) that are otherwise not covered in the previous "other" lines. Therefore, "Sum Line 24" is the sum of all the lines 24.

Range* of total profit (loss) margins

= Total margin for METRO NASHVILLE GENERAL HOSPITAL compared to all** acute-care hospitals, from CMS cost reports.
The chart below is interactive: click or touch to see more.

2017	2018	2019	2020	2021
3,157	3,092	3,050	3,052	2,566

Medicare revenue

Inpatient and outpatient revenue

	2017	2018	2019	2020	2021
All inpatient revenue Median Click here to show/hide details	4,883,578 23,241,334	5,780,269 23,709,545	7,107,346 24,248,380	7,818,181 22,858,541	10,071,236 23,620,613
"All inpatient revenue" is made up of any Medicare payments for routine inpatient, swingbed SNFs, TEFRA, IPF, IRF, inpatient long-term care, CAH and inpatient SNF facilities. Medians are only calculated when there are sufficient facilities reporting revenue.
⊳ Routine inpatient revenue ⊳ Median	4,883,578 21,577,146	5,780,269 22,041,594	7,107,346 22,722,063	7,818,181 21,570,441	10,071,236 22,140,684
⊳ Swingbeds ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Tax Equity and Fiscal Responsibility Act payments (TEFRA) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Inpatient psychiatric facility (IPF) ⊳ Median	0 1,845,420	0 1,757,392	0 1,738,842	0 1,510,463	0 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	0 3,535,627	0 3,746,588	0 3,782,288	0 3,865,578	0 3,983,889
⊳ Long-term care hospital (LTCH) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Critical-access hospitals ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Skilled-nursing facilities (SNF) ⊳ Median	0 1,203,033	0 1,215,295	0 1,313,657	0 1,365,298	0 1,179,746
All outpatient revenue Median Click here to show/hide details	2,192,442 11,160,864	2,358,806 11,987,345	1,929,776 12,926,866	1,827,361 11,884,480	1,850,270 13,145,163
"All outpatient revenue" is made up of any payments for routine outpatient, HHA, CMHC, rural health and other federally-qualified health clinics. Medians are only calculated when there are sufficient facilities reporting revenue.
⊳ Routine outpatient revenue ⊳ Median	2,192,442 10,918,923	2,358,806 11,706,976	1,929,776 12,615,917	1,827,361 11,458,116	1,850,270 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	0 1,282,808	0 1,407,728	0 1,341,512	0 1,407,046	0 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	0 618,038	0 697,279	0 690,232	0 684,010	0 670,558
⊳ Other federally qualified health clinics ⊳ Median	0 --	0 --	0 --	0 --	0 --

Other payments

Item	2017	2018	2019	2020	2021
Graduate Medical Education (GME) Median	1,432,574 3,284,314	1,316,045 3,250,551	975,472 3,386,837	956,558 3,360,806	1,230,847 3,508,953
Disproportionate-share hospital (DSH) Median	144,312 594,888	131,658 595,761	89,420 577,894	76,009 542,168	120,260 549,667
Outlier Median	186,997 582,572	91,243 538,116	36,734 212,434	2,219 126,559	75,066 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	10,238,462 3,662,910	13,857,148 3,730,911	10,315,124 4,081,319	10,713,923 4,643,908	9,229,346 4,389,147
Charity care Median	14,418,773 2,654,636	17,309,295 2,940,659	21,894,381 3,380,215	22,152,502 3,488,738	19,883,224 3,233,405
Uncompensated care (UCC) Median	24,986,785 5,147,790	30,012,020 5,337,617	30,816,981 5,711,082	31,679,781 5,923,418	28,514,588 5,508,107
UCC as a % of operating expenses Median	24.03% 3.24	28.94% 3.12	29.39% 3.21	29.11% 3.3	24.16% 2.86
Total shortfall/UCC Median	35,225,247 9,489,989	43,869,168 9,424,297	41,132,105 10,120,158	42,393,704 11,171,337	37,743,934 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	37,118,765 52,142,039	33,939,408 54,485,252	35,690,599 57,395,589	39,574,964 58,830,919	44,709,082 61,722,907
Salaries as a % of operating expenses Median	35.69 36.68	32.72 36.56	34.03 36.37	36.36 35.93	37.88 35.24
Intern, resident salaries* Median	0 2,598,592	0 2,686,824	0 2,753,773	0 2,937,156	0 2,909,848
Contract intern, resident salaries* Median	0 1,251,927	0 1,186,494	0 1,204,885	0 1,279,653	0 1,469,317
Contract adjusted salaries, direct-care Median	1,200,839 1,449,244	4,343,996 1,475,986	3,776,789 1,563,078	3,178,527 1,721,954	5,424,821 2,991,828
Contract hours, direct-care Median	24,293.22 22,725	73,731.74 23,018.5	55,016.12 24,503.48	49,094.59 25,026.5	68,821.75 33,786
Contract wages, direct-care Median	49.43 64.67	58.92 64.53	68.65 65.06	64.74 68.97	78.82 88.94

* in an approved program

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Cost reports are self-reported by the facility, are subject to revision and should be considered preliminary.

* Net Service to patients (NS2P) equals net patient revenue minus operating expenses. NS2P is considered the equivalent of operating profit according to the Medicaid and CHIP Payment and Access Commission (MACPAC). See the last paragraph of "Primary Data Sources" on page 55 of Annual Analysis of Disproportionate Share Hospital Allotments to States (PDF).

About medians

Medians are calculated from reports with "complete" fiscal years, or reports with fiscal years of at least 300 days and no more than 420 days.

In cases where there are fewer than 50 values reported, medians are not calculated. For childrens' hospitals, it's when fewer than 20 are reported.

Web app by Tim Broderick | email.